Question

A nurse is planning care for a client who has hyperthyroidism and is receiving radioactive iodine (radioiodine). Which of the following statements by the nurse regarding special precautions is appropriate?

Answer 1

Correct Answers:

"You will need to use a bathroom separate from other household members."

Rationale :

✔️Clients receiving radioactive iodine (RAI) treatment for hyperthyroidism emit small amounts of radiation through urine, saliva, and sweat for several days.

✔️To prevent exposure to family members, the client should use a separate toilet, flush twice, and wash hands thoroughly after each use.

✔️They should also avoid close physical contact, especially with children and pregnant individuals, for at least 3–7 days, depending on the dose.

✔️Separate laundry and eating utensils should be used temporarily to reduce cross-contamination risk.

✔️These precautions protect others while allowing the client to safely undergo treatment at home.

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Answer 2

Correct Answers:

Serum bicarbonate less than 15

Rationale :

🔷Diabetic ketoacidosis (DKA) is characterized by metabolic acidosis due to accumulation of ketone bodies.

🔷A serum bicarbonate level <15 mEq/L confirms metabolic acidosis and correlates with increased acid-base imbalance severity.

🔷Other DKA markers include low pH (<7.3), elevated blood glucose (>250 mg/dL), and positive urine/serum ketones.

🔷This condition occurs primarily in type 1 diabetes when insulin deficiency leads to fat breakdown and ketone production.

🔷Prompt management with IV fluids, insulin, and electrolyte replacement is essential to correct acidosis.

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Answer 3

Correct Answers:

Albumin

Rationale :

✨Albumin, a plasma protein synthesized by the liver, is a key indicator of liver function and nutritional status.

✨Low serum albumin levels reflect impaired protein synthesis due to hepatic dysfunction, as seen in cirrhosis or hepatitis.

✨Hypoalbuminemia leads to edema and ascites due to decreased oncotic pressure in the vascular system.

✨Albumin testing is part of the liver function panel, along with ALT, AST, and bilirubin levels.

✨Monitoring albumin levels helps assess disease progression and response to treatment.

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Answer 4

Correct Answers:

Cease from smoking and consuming alcohol.

Rationale :

🟢Clients recovering from acute pancreatitis must completely avoid alcohol and smoking, both of which stimulate pancreatic enzyme secretion and worsen inflammation.

🟢Alcohol increases the risk of recurrent attacks and chronic pancreatitis, while smoking promotes pancreatic fibrosis.

🟢Dietary modifications such as low-fat, small, frequent meals are also recommended to reduce pancreatic workload.

🟢Patient teaching should emphasize hydration and follow-up care to monitor for complications like pseudocysts or diabetes.

🟢Abstinence from these substances significantly improves long-term pancreatic recovery and prognosis.

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Answer 5

Correct Answers:

"Keeping supplies on hand to treat hypoglycemic episodes is important."

Rationale :

🔶Clients with type 1 diabetes mellitus are at risk for hypoglycemia, especially from excess insulin, skipped meals, or overexertion.

🔶Keeping rapid-acting glucose sources (e.g., glucose tablets, juice, candy) available ensures immediate correction when symptoms appear.

🔶Early treatment prevents progression to loss of consciousness or seizures.

🔶Education should also include recognizing early symptoms such as tremors, diaphoresis, and confusion.

🔶Consistent monitoring and preparedness reinforce self-management and safety for diabetic clients.

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Answer 6

Correct Answers:

"Avoid foods that have been fried."

Rationale :

💠Fried and fatty foods irritate the gastric mucosa and stimulate acid production, increasing the risk of peptic ulcer formation or aggravation.

💠Clients with a family history of GI bleed or ulcers should also limit NSAIDs, caffeine, and alcohol, which damage the stomach lining.

💠A balanced diet rich in fiber, fruits, and lean protein supports mucosal healing and overall GI health.

💠Stress reduction and smoking cessation are additional protective measures.

💠Education on avoiding gastric irritants is essential for ulcer prevention and long-term digestive wellness.

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Answer 7

Correct Answers:

"A hiatal hernia might increase your risk for GERD."

Rationale :

🟣A hiatal hernia occurs when part of the stomach protrudes through the diaphragm into the thoracic cavity, weakening the lower esophageal sphincter (LES).

🟣This leads to acid reflux and increases the risk of gastroesophageal reflux disease (GERD).

🟣Symptoms include heartburn, regurgitation, and dysphagia, especially after meals or when lying flat.

🟣Education includes small frequent meals, avoiding lying down post-meal, elevating the head of bed, and avoiding tight clothing.

🟣Recognizing this relationship enables clients to manage symptoms and prevent esophageal irritation.

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Answer 8

Correct Answers:

Lower abdominal pain
Hypertension
Mental confusion

Rationale :

Lower abdominal pain

🔷Pyelonephritis is an upper urinary tract infection involving the renal pelvis and kidney parenchyma, producing visceral pain that patients may perceive as lower abdominal or flank pain.

🔷The pain arises from renal capsular stretch and inflammation, often accompanied by costovertebral angle (CVA) tenderness, fever, and chills.

🔷Because the kidneys share neural pathways with adjacent areas, pain can refer anteriorly, explaining lower abdominal discomfort.

🔷Persistent pain coupled with systemic signs helps distinguish pyelonephritis from isolated cystitis, which is typically limited to suprapubic discomfort.

🔷Recognizing pattern + location of pain guides the nurse to escalate assessment (urinalysis, cultures) and initiate timely antimicrobial therapy.

Hypertension

🔷Infection-driven renal parenchymal inflammation can impair sodium–water handling and activate renin–angiotensin–aldosterone pathways, producing elevations in blood pressure.

🔷In acute pyelonephritis, intravascular volume shifts and pain-related sympathetic tone may further raise blood pressure.

🔷Recurrent or severe infections can lead to scarring that contributes to secondary (renovascular) hypertension.

🔷Detecting hypertension prompts strict hemodynamic monitoring and fluid management to protect renal perfusion.

🔷Managing BP + infection together reduces risk of AKI and supports renal recovery.

Mental confusion

🔷In older adults, delirium or acute confusion is a common atypical presentation of systemic infection, including pyelonephritis.

🔷Inflammatory cytokines, fever, pain, and fluid–electrolyte changes disrupt neurotransmission, precipitating acute cognitive fluctuations.

🔷Confusion can predate fever or leukocytosis, making it a critical early clue to investigate infection.

🔷Nursing recognition of new-onset confusion should trigger rapid assessment, including vitals, urinalysis, and possible sepsis screening.

🔷Early identification and treatment reduce complications, length of stay, and risk of functional decline.

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Answer 9

Correct Answers:

Drink plenty of fluids during the day.

Rationale :

➡️Adequate hydration prevents urinary concentration, reducing crystal formation and recurrent renal calculi (kidney stones).

➡️Clients working in hot environments are prone to dehydration, which promotes stone formation, especially in those with gout or hyperuricemia.

➡️The goal is to maintain urine output of 2–3 liters per day and light-yellow urine color.

➡️Fluids help flush calcium, oxalate, and uric acid crystals before they accumulate.

➡️Encouraging hydration is the most effective and evidence-based preventive strategy for kidney stones.

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Answer 10

Correct Answers:

"I will weigh myself daily and keep track of my weight in my dialysis record."
"l will check my blood pressure and follow the instructions related to changes I might need to do based on the results.”
"l must wash my hands every time before I connect the tubing to the catheter in my stomach.”

Rationale :

“I will weigh myself daily and keep track of my weight in my dialysis record.”

🟣Daily weights taken under consistent conditions (same scale, time of day, clothing) are the most sensitive bedside indicator of net fluid balance during CAPD.

🟣A sudden gain (e.g., >1–2 kg in 24–48 hr) signals fluid overload or inadequate ultrafiltration, prompting review of dwell time, fill volumes, and dextrose concentration.

🟣Trending weight in a dialysis log enables the team to correlate changes with effluent volumes, residual urine output, diet/sodium intake, and symptoms (edema, dyspnea).

🟣Accurate tracking supports early intervention (e.g., higher dextrose dialysate, dietary adjustment, evaluation for catheter issues) to prevent pulmonary edema or hospitalization.

🟣Emphasizing weight trend + symptoms + outputs provides a comprehensive picture of volume status and CAPD adequacy.

“I will check my blood pressure and follow the instructions related to changes I might need to do based on the results.”

🟣Blood pressure (BP) is a direct proxy for intravascular volume; hypertension typically reflects volume excess, while symptomatic hypotension can follow excess ultrafiltration.

🟣Routine home BP monitoring—documented alongside daily weight and symptoms—helps distinguish true volume issues from medication or dietary factors (e.g., sodium intake).

🟣Clear parameters (for example, SBP >160–170 mmHg or <90 mmHg, or new dizziness, syncope) should trigger contact with the dialysis team for prescription or diet adjustments.

🟣Timely responses to abnormal BP prevent end-organ strain (cardiac, cerebrovascular) and support safe titration of antihypertensives in parallel with dialysis changes.

🟣Integrating BP trends into the care plan strengthens self-management, reduces acute care visits, and improves long-term cardiovascular outcomes in PD patients.

“I must wash my hands every time before I connect the tubing to the catheter in my stomach.”

🟣Peritonitis is the leading CAPD complication and most often results from touch contamination at the connect/disconnect steps.

🟣Meticulous hand hygiene (soap and water with proper friction and drying or approved sanitizer) and aseptic technique before every exchange dramatically lower infection risk.

🟣Education should include preparing a clean field, minimizing talking/coughing during connection, and following any mask policy per program protocol.

🟣Early recognition of peritonitis warning signs—cloudy effluent, abdominal pain, fever, nausea—and immediate reporting allows prompt cultures and intraperitoneal antibiotics, preserving the peritoneal membrane.

🟣Consistent infection-prevention steps protect dialysis adequacy, reduce hospitalizations, and prolong technique survival on PD.

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Custom Adult Health II Final Exam Fall 2025

No.

1 :
A nurse is planning care for a client who has hyperthyroidism and is receiving radioactive iodine (radioiodine). Which of the following statements by the nurse regarding special precautions is appropriate?

2 :
A nurse is providing care for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client most likely to be diagnosed with diabetic ketoacidosis (OKA)?

3 :
A nurse is collecting data from a client's laboratory results. Which of the following lab values is usually tested with a diagnosis of liver disease?

4 :
A nurse is reinforcing teaching with a client who is being discharged after treatment for acute pancreatitis. Which of the following statements is important to include in the information?

5 :
A nurse is reinforcing education with a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

6 :
A nurse is caring for a client who states their parent died from complications of a GI bleed. Which of the following reinforcements by the nurse will help the client decrease their risk of developing a peptic ulcer?

7 :
A nurse is reinforcing teaching with a client who has recently been diagnosed with a hiatal hernia. Which of the following new information will be beneficial for the nurse to relay to the client?

8 :
A nurse is gathering data on a client who was admitted with pyelonephritis. Which of the following manifestations should the nurse expect the client to be exhibiting? (Select All that Apply.)

10 :
A nurse is assisting the registered nurse provide discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis at home. Which of the following client statements indicate understanding of this type of dialysis management? (Select All that Apply.)

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Custom Adult Health II Final Exam Fall 2025

No.

1 : A nurse is planning care for a client who has hyperthyroidism and is receiving radioactive iodine (radioiodine). Which of the following statements by the nurse regarding special precautions is appropriate?

2 : A nurse is providing care for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client most likely to be diagnosed with diabetic ketoacidosis (OKA)?

3 : A nurse is collecting data from a client's laboratory results. Which of the following lab values is usually tested with a diagnosis of liver disease?

4 : A nurse is reinforcing teaching with a client who is being discharged after treatment for acute pancreatitis. Which of the following statements is important to include in the information?

5 : A nurse is reinforcing education with a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

6 : A nurse is caring for a client who states their parent died from complications of a GI bleed. Which of the following reinforcements by the nurse will help the client decrease their risk of developing a peptic ulcer?

7 : A nurse is reinforcing teaching with a client who has recently been diagnosed with a hiatal hernia. Which of the following new information will be beneficial for the nurse to relay to the client?

8 : A nurse is gathering data on a client who was admitted with pyelonephritis. Which of the following manifestations should the nurse expect the client to be exhibiting? (Select All that Apply.)

10 : A nurse is assisting the registered nurse provide discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis at home. Which of the following client statements indicate understanding of this type of dialysis management? (Select All that Apply.)

1 :
A nurse is planning care for a client who has hyperthyroidism and is receiving radioactive iodine (radioiodine). Which of the following statements by the nurse regarding special precautions is appropriate?

2 :
A nurse is providing care for a client who has diabetes mellitus. Which of the following laboratory findings indicates the client most likely to be diagnosed with diabetic ketoacidosis (OKA)?

3 :
A nurse is collecting data from a client's laboratory results. Which of the following lab values is usually tested with a diagnosis of liver disease?

4 :
A nurse is reinforcing teaching with a client who is being discharged after treatment for acute pancreatitis. Which of the following statements is important to include in the information?

5 :
A nurse is reinforcing education with a client who has type 1 diabetes mellitus and has been experiencing hypoglycemic episodes. Which of the following statements by the nurse is appropriate?

6 :
A nurse is caring for a client who states their parent died from complications of a GI bleed. Which of the following reinforcements by the nurse will help the client decrease their risk of developing a peptic ulcer?

7 :
A nurse is reinforcing teaching with a client who has recently been diagnosed with a hiatal hernia. Which of the following new information will be beneficial for the nurse to relay to the client?

8 :
A nurse is gathering data on a client who was admitted with pyelonephritis. Which of the following manifestations should the nurse expect the client to be exhibiting? (Select All that Apply.)

10 :
A nurse is assisting the registered nurse provide discharge teaching to a client who will be performing continuous ambulatory peritoneal dialysis at home. Which of the following client statements indicate understanding of this type of dialysis management? (Select All that Apply.)